An adult patient is having a nosebleed. You should

• A. Pinch the nostrils
• B. Tilt the head back
• C. Pack with cotton
• D. Apply ice to nose

Answer: (A)

Direct pressure on the soft part of the nose is the quickest and most effective way to stop a common adult nosebleed. The bleeding usually comes from a front area of the nasal septum where vessels are close to the surface; squeezing the nostrils compresses those vessels, helps form a clot, and reduces ongoing blood loss.

Do this by sitting up and leaning slightly forward, then pinch the soft lower part of the nose with your fingers for about 5 to 10 minutes without releasing. This forward posture prevents blood from running back into the throat and helps you monitor the situation.

Tilting the head back is not advised because it can cause blood to run down the throat, which may lead to coughing or choking and does not actually stop the bleeding.

Packing with cotton or other materials is a more involved step and is not the first measure a layperson should take; it’s typically done by a clinician if bleeding continues. Ice on the bridge of the nose can be a helpful adjunct but does not substitute for direct pressure.

So, the best initial action is to pinch the nostrils to apply direct pressure and allow clotting to occur.